Donor corneal tissue management

1337 although the scientific evidence is inconclusive. Problems associated with prophylactic antibiotics include selection of more resistant organisms, the development of resistant bacteria, allergic reactions, and expense. Most surgeons who give preoperative antibiotics use a broad-spectrum, relatively nonsensitizing drug for 1–3 days before surgery. The most common source of endophthalmitis is the patient’s periocular flora. Careful attention to the management and elimination of blepharitis preoperatively is important. Likewise, preoperative lid preparation is important, with special attention given to removing any residual lid margin debris. The lashes should be fully covered with adherent drapes to isolate them from the operative field. In addition, a single application of one drop of 5% povidoneiodine solution on the ocular surface, at the time of the surgical preparation, has been shown to reduce significantly the incidence of endophthalmitis. The solution should be irrigated from the eye before making any incisions to avoid possible intraocular toxicity.